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Femoroazetabuläres Impingement bei Sportlern

Pathologie, Diagnostik und operative Therapieoptionen

Femoroacetabular impingement in athletes

Pathology, diagnostics and operative therapy options

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Zusammenfassung

Das femoroazetabuläre Impingement (FAI) und dessen Therapie haben in den letzten Jahren an Bedeutung gewonnen. Es konnte in zahlreichen Studien gezeigt werden, dass es sich um eine präarthrotische Deformität handelt, die unbehandelt zur Koxarthrose führt. Dieser Beitrag soll einen Überblick über die Pathologie, Diagnostik und die operativen Therapien, gerade auch im Hinblick auf den aktiven Sportler, geben. Erste eigene klinische und radiologische Ergebnisse von 91 Patienten, die durch arthroskopisch assistierte Mini-open-Arthrotomie behandelt wurden, werden vorgestellt. Sie zeigen sehr gute Ergebnisse und signifikante postoperative Verbesserungen im Hinblick auf HOOS-, WOMAC- und UCLA-Activity-Score sowie die Korrektur des α-Winkels. Diese in der Literatur vergleichsweise noch wenig beachtete Operationstechnik steht als Therapieoption zur Behandlung des FAI zur Verfügung. Die Nachbehandlung ist mit der der Hüftarthroskopie gleichzusetzen.

Abstract

Femoroacetabular impingement (FAI) and its therapy has gained importance in the last decade and several studies could show that if untreated it may lead to osteoarthritis of the hip joint. In this article an overview of the pathology of FAI, the diagnosis and treatment options are presented. A closer look is taken at the treatment of elite athletes regarding the different techniques. The first own clinical and radiological results of 91 patients treated by the arthroscopically-assisted anterior mini-open approach are presented with very good results and significant postoperative improvement regarding the hip injury and osteoarthritis outcome score (HOOS), the Western Ontario and McMasters University (WOMAC) osteoarthritis index and the University of California Los Angeles (UCLA) activity score, as well as alpha angle correction. This technique which is poorly represented in the literature can be used as a treatment option for FAI. The rehabilitation program is comparable to hip arthroscopy.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Ezechieli und H. Windhagen geben an, dass kein Interessenkonflikt besteht. Alle im vorliegenden Manuskript beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethikkommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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  1. Orthopädische Klinik der Medizinischen Hochschule Hannover im Annastift, Anna-von-Borries-Str. 1–7, 30625, Hannover, Deutschland

    M. Ezechieli & H. Windhagen

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  1. M. Ezechieli
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  2. H. Windhagen
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Correspondence to M. Ezechieli.

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Ezechieli, M., Windhagen, H. Femoroazetabuläres Impingement bei Sportlern. Chirurg 85, 872–878 (2014). https://doi.org/10.1007/s00104-014-2771-5

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